Classifying health workers: Mapping occupations to the ...

[Pages:14]Classifying health workers: Mapping occupations to the international standard classification

The international classification of health workers is largely based on the International Standard Classification of Occupations (ISCO, 2008 revision), a system for classifying and aggregating occupational information obtained by means of population censuses and other statistical surveys, as well as from administrative records. The classification uses a hierarchical structure of occupational titles and codes, essentially reflecting the distinction of subgroups of the health workforce according to assumed differences in skill level and skill specialization required to fulfil the tasks and duties of jobs. The ISCO tool is intended both for statistical users and for client oriented users, and is the basis for many national occupational classifications.

This mapping gives guidelines on how health workers are to be classified into the most detailed groups, with examples of occupations included and excluded, for purposes of statistical delineation, description and analysis. It is intended to serve as a model to facilitate communication about health occupations, to enhance comparability of data on health workers within and across countries and over time, and to make it possible for data and information on health workers obtained from different sources to be produced in a form which can be useful for research as well as for decision-making and action-oriented activities. It is recognized that the full complexity and dynamics of national health labour markets may not be captured.

The classification of health workers maps occupation categories into five broad groupings: health professionals, health associate professionals, personal care workers in health services, health management and support personnel, and other health service providers not elsewhere classified.

Occupation group ISCO code Definition HEALTH PROFESSIONALS

Examples of occupations classified here

Notes

Health professionals study, advise on or provide preventive, curative, rehabilitative and promotional health services based on an extensive body of theoretical and factual knowledge in diagnosis and treatment of disease and other health problems. They may conduct research on human disorders and illnesses and ways of treating them, and supervise other workers. The knowledge and skills required are usually obtained as the result of study at a higher educational institution in a health-related field for a period of 3?6 years leading to the award of a first degree or higher qualification.

Generalist medical practitioners

2211

Generalist medical doctors (including family and Medical doctor (general), Medical officer (general),

primary care doctors) diagnose, treat and prevent Physician (general), General practitioner, Family

illness, disease, injury, and other physical and

medical practitioner, Primary health care physician,

mental impairments and maintain general health in District medical doctor, Resident medical officer

humans through application of the principles and specializing in general practice

procedures of modern medicine. They plan,

supervise and evaluate the implementation of care

and treatment plans by other health care providers.

They do not limit their practice to certain disease

categories or methods of treatment, and may

assume responsibility for the provision of

continuing and comprehensive medical care to

individuals, families and communities.

Occupations included in this category require completion of a university-level degree in basic medical education plus postgraduate clinical training or equivalent. Medical interns who have completed their university education in basic medical education and are undertaking postgraduate clinical training are included here. Although in some countries `general practice' and 'family medicine' may be considered as medical specializations, these occupations should always be classified here.

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Classification of health workforce statistics, World Health Organization, Geneva who.int/hrh/statistics/workforce_statistics Contact: hrhstatistics@who.int

Occupation group Specialist medical practitioners *

ISCO code 2212

Definition

Specialist medical doctors diagnose, treat and prevent illness, disease, injury and other physical and mental impairments using specialized testing, diagnostic, medical, surgical, physical and psychiatric techniques, through application of the principles and procedures of modern medicine. They plan, supervise and evaluate the implementation of care and treatment plans by other health care providers. They specialize in certain disease categories, types of patient or methods of treatment, and may conduct medical education and research activities in their chosen areas of specialization.

Examples of occupations classified here Specialist physician (internal medicine), Surgeon, Anaesthetist, Cardiologist, Emergency medicine specialist, Ophthalmologist, Gynaecologist, Obstetrician, Paediatrician, Pathologist, Preventive medicine specialist, Psychiatrist, Radiologist, Resident medical officer in specialist training

Notes Occupations included in this category require completion of a university-level degree in basic medical education plus postgraduate clinical training in a medical specialization (except general practice) or equivalent. Resident medical officers training as specialist practitioners (except general practice) are included here. Although in some countries 'stomatology' may be considered as a medical specialization, stomatologists should be included under 'Dentists'-2261. Medical research professionals who participate in biomedical research using living organisms and do not undertake clinical practice should be excluded from here (classified under 'Life science professionals').

* Medical doctors by specialty groupings

Doctors in obstetric and gynaecological

Gynaecologist, Obstetrician

specialties and related branches focusing on the

care of the reproductive system of women

including before, during and after pregnancy and

childbirth.

Doctors in paediatrics and related specialties Paediatrician, Neonatologist

focusing on the prevention, diagnosis and treatment of health problems in infants, children and adolescents.

It is of significance to countries and stakeholders to be able to distinguish the different categories of specialist medical practitioners. For purposes of international comparability, where data pertaining to specialist medical practitioners are reported and classified by medical specialty, they should be mapped to these groupings. Each specialist should only be counted once, according to the main area of practice (or, if this information is not available, the last specialty registered).

Doctors in psychiatric specialties and related Psychiatrist, Child psychiatrist, Gerontopsychiatrist, branches focusing on the study and treatment of Neuropsychiatrist mental illness and behavioural disorders.

Doctors in the medical group of specialties Specialist medical doctor in cardiology, dermato-

and related branches (not elsewhere classified) venerology, forensic medicine, gastroenterology,

focusing on the diagnosis, management and non- haematology, immunology, infectious disease,

surgical treatment of health problems.

internal medicine, neurology, occupational medicine,

oncology, radiology, rehabilitative medicine,

respiratory medicine, urology

Doctors in the surgical group of specialties Specialist medical doctor in general surgery, accident

and related branches (not elsewhere classified) and emergency medicine, anaesthesiology, intensive

focusing on the treatment of health problems with care, neurological surgery, ophthalmology,

surgery.

orthopaedics, otolaryngology, paediatric surgery,

plastic surgery, thoracic surgery, vascular surgery

Doctors in specialties not elsewhere classified includes medical doctors in specialist practice excepting obstetric, gynaecological, paediatric, psychiatric, surgical or medical specialties as classified elsewhere.

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Classification of health workforce statistics, World Health Organization, Geneva who.int/hrh/statistics/workforce_statistics Contact: hrhstatistics@who.int

Occupation group Nursing professionals

ISCO code 2221

Definition

Examples of occupations classified here

Nursing professionals provide treatment, support Professional nurse, Specialist nurse, Nurse

and care services for people who are in need of practitioner, Clinical nurse, District nurse, Operating

nursing care due to the effects of ageing, injury, theatre nurse, Public health nurse, Nurse

illness or other physical or mental impairment, or anaesthetist, Nurse educator

potential risks to health, according to the practice

and standards of modern nursing. They assume

responsibility for the planning and management of

the care of patients, including the supervision of

other health care workers, working autonomously

or in teams with medical doctors and others in the

practical application of preventive and curative

measures in clinical and community settings.

Notes This category includes occupations for which competent performance usually requires formal training at a higher educational institution in nursing. The distinction between nursing and midwifery professionals and associate professionals should be made on the basis of the nature of the work performed in relation to this definition. The qualifications held by individuals or that predominate in the country are not the main factor in making this distinction, as training arrangements for nurses and midwives vary widely between countries and have varied over time within countries.

Midwifery professionals

Traditional and complementary medicine professionals

2222

Midwifery professionals plan, manage, provide Professional midwife and evaluate midwifery care services before, during and after pregnancy and childbirth. They provide delivery care for reducing health risks to women and newborn children according to the practice and standards of modern midwifery, working autonomously or in teams with other health care providers. They may conduct research on midwifery practices and procedures, and implement midwifery education activities in clinical and community settings.

This category includes occupations for which competent performance usually requires formal training at a higher educational institution in midwifery. The distinctions between nursing and midwifery professionals and associate professionals should be made on the basis of the nature of the work performed in relation to this definition. The qualifications held by individuals or that predominate in the country are not the main factor in making this distinction, as training arrangements for nurses and midwives vary widely between countries and have varied over time within countries.

2230

Traditional and complementary medicine professionals examine patients and prevent and treat illness, disease, injury and other physical, mental and psychosocial ailments by applying knowledge, skills and practices acquired through extensive study of the theories and experiences originating in specific cultures. They research, develop and implement treatment plans using applications such as acupuncture, ayurvedic, homoeopathic and herbal medicine.

Acupuncturist, Ayurvedic practitioner, Chinese herbal This category includes occupations for which competent

medicine practitioner, Homeopath, Naturopath, Unani performance requires an extensive understanding of the

practitioner

benefits and applications of traditional and complementary

therapies, developed as the result of extended formal study

of these techniques as well as human anatomy and elements

of modern medicine. Practitioners working in the singular

application of approaches to herbal medicines, spiritual

therapies or manual therapeutic activity are excluded from

here.

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Occupation group Paramedical practitioners

ISCO code 2240

Definition

Examples of occupations classified here

Paramedical practitioners (including clinical

Clinical officer, Primary care paramedic, Advanced

officers and related) provide advisory, diagnostic, care paramedic, Surgical technician, Feldsher

curative and preventive medical services more

limited in scope and complexity than those carried

out by medical doctors. They work autonomously or

with limited supervision of medical doctors, and

perform clinical, therapeutic and surgical

procedures for treating and preventing diseases,

injuries, and other physical or mental impairments

common to specific communities.

Notes Occupations included in this category normally require completion of tertiary-level training in theoretical and practical medical services. Workers providing services limited to emergency treatment and ambulance practice are classified under 'Ambulance workers'-3258.

Dentists

2261

Dentists (including dental surgeons and related) diagnose, treat and prevent diseases, injuries and abnormalities of the teeth, mouth, jaws and associated tissues by applying the principles and procedures of modern dentistry. They use a broad range of specialized diagnostic, surgical and other techniques to promote and restore oral health.

Dentist, Dental practitioner, Dental surgeon, Endodontist, Oral and maxillofacial surgeon, Oral pathologist, Orthodontist, Paedodontist, Periodontist, Prosthodontist, Stomatologist

Occupations included in this category normally require completion of university-level training in theoretical and practical dentistry or a related field. Although in some countries `stomatology' and 'dental, oral and maxillofacial surgery' may be considered as medical specializations, occupations in these fields should always be classified here.

Pharmacists

Environmental and occupational health and hygiene professionals

2262

Pharmacists store, preserve, compound and dispense medicinal products. They counsel on the proper use and adverse effects of drugs and medicines following prescriptions issued by medical doctors and other health professionals. They contribute to researching, testing, preparing, prescribing and monitoring medicinal therapies for optimizing human health.

Hospital pharmacist, Industrial pharmacist, Retail pharmacist, Dispensing chemist

Occupations included in this category normally require completion of university-level training in theoretical and practical pharmacy, pharmaceutical chemistry or a related field. Pharmacologists and related professionals who study living organisms are excluded from here (classified under 'Life science professionals').

2263

Environmental and occupational health and Environmental health officer, Occupational health and This category includes occupations for which competent

hygiene professionals assess, plan and

safety adviser, Occupational hygienist, Radiation

performance usually requires formal training at a higher

implement programs to recognize, monitor and protection adviser

educational institution in environmental or occupational

control environmental factors that can potentially

health and safety, or a related field. Professionals who

affect human health, to ensure safe and healthy

assess, plan and implement programmes to monitor or

working conditions, and to prevent disease or injury

control the impact of human activities on the environment are

caused by chemical, physical, radiological and

excluded from here (classified under 'Life science

biological agents or ergonomic factors.

professionals').

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Occupation group Physiotherapists

ISCO code 2264

Definition

Examples of occupations classified here

Physiotherapists assess, plan and implement Physiotherapist, Geriatric physical therapist,

rehabilitative programs that improve or restore

Orthopaedic physical therapist, Paediatric physical

human motor functions, maximize movement

therapist

ability, relieve pain syndromes, and treat or prevent

physical challenges associated with injuries,

diseases and other impairments. They apply a

broad range of physical therapies and techniques

such as movement, ultrasound, heating, laser and

other techniques. They may develop and

implement programmes for screening and

prevention of common physical ailments and

disorders.

Notes This category includes occupations for which competent performance usually requires formal training at a higher educational institution in physiotherapy or a related field.

Dieticians and nutritionists

Audiologists and speech therapists

2265

Dieticians and nutritionists assess, plan and Dietician, Clinical dietician, Food service dietician, implement programs to enhance the impact of food Nutritionist, Public health nutritionist, Sports and nutrition on human health. They may conduct nutritionist research, assessments and education to improve nutritional levels among individuals and communities.

This category includes occupations for which competent performance usually requires formal training at a higher educational institution in food and nutritional science, nutrition education, dietetics, or a related field.

2266

Audiologists and speech therapists evaluate, manage and treat physical disorders affecting human hearing, speech communication and swallowing. They prescribe corrective devices or rehabilitative therapies for hearing loss, speech disorders, and related sensory and neural problems. They plan hearing screening programs and provide counselling on hearing safety and communication performance.

Audiologist, Speech therapist, Speech pathologist, Language therapist

This category includes occupations for which competent performance usually requires formal training at a higher educational institution in audiology, speech pathology, clinical language sciences or a related field.

Optometrists and opthalmic opticians

Health professionals not elsewhere classified

2267

Optometrists and ophthalmic opticians provide Optometrist, Ophthalmic optician, Orthoptist diagnosis, management and treatment services for disorders of the eyes and visual system. They counsel and advise on eye care and safety, and prescribe optical aids or other therapies for visual disturbance.

2269

This group covers health professionals not

Podiatrist, Occupational therapist, Recreational

classified elsewhere such as podiatrists,

therapist, Arts therapist, Dance and movement

occupational therapists, recreational therapists and therapist

other professionals providing diagnostic,

preventive, curative and rehabilitative health

services.

This category includes occupations for which competent performance usually requires formal training at a higher educational institution in optometry, orthoptics or a related field.

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Occupation group ISCO code Definition HEALTH ASSOCIATE PROFESSIONALS

Examples of occupations classified here

Notes

Health associate professionals perform technical and practical tasks to support diagnosis and treatment of illness, disease, injuries and impairments, and to support implementation of health care, treatment and referral plans usually established by medical, nursing and other health professionals. Appropriate formal qualifications are often an essential requirement for entry to these occupations; in some cases relevant work experience and prolonged on-the-job training may substitute for the formal education.

Medical imaging and therapeutic equipment technicians

3211

Medical imaging and therapeutic equipment Diagnostic medical radiographer, Medical radiation

technicians test and operate radiographic,

therapist, Magnetic resonance imaging technologist,

ultrasound and other medical imaging equipment to Nuclear medicine technologist, Mammographer,

produce images of body structures for the

Sonographer

diagnosis and treatment of injury, disease and

other impairments. They may administer radiation

treatments and monitor patients' conditions under

the supervision of a radiologist or other health

professional.

This category includes occupations for which competent performance usually requires formal training in medical technology, radiology, sonography, nuclear medical technology or a related field.

Medical and pathology laboratory technicians

3212

Medical and pathology laboratory technicians Medical laboratory technician, Medical laboratory This category includes occupations for which competent

perform clinical tests on specimens of bodily fluids assistant, Blood bank technician, Cytology technician, performance usually requires formal training in biomedical

and tissues in order to get information about the Pathology technician

science, medical technology or a related field. Technicians

health of a patient or cause of death. They test and

who conduct laboratory tests on living organisms should be

operate equipment such as spectrophotometers,

classified under 'Life science technicians'. Forensic science

calorimeters and flame photometers for analysis of

technicians, who perform clinical tests to aid in the

biological material including blood, urine and spinal

investigation of crimes, should be classified under 'Physical

fluid.

and engineering science technicians'.

Pharmaceutical technicians and assistants

Medical and dental prosthetic technicians

3213

Pharmaceutical technicians and assistants

Pharmaceutical technician, Pharmaceutical assistant, Occupations included in this category normally require

perform a variety of tasks associated with

Dispensing technician

knowledge and skills in pharmaceutical services as obtained

dispensing medicinal products under the guidance

through formal training. Pharmacology technicians and

of a pharmacist or other health professional. They

related associate professionals who work with living

inventory, prepare and store medications and other

organisms are excluded from here (classified under 'Life

pharmaceutical compounds and supplies, and may

science technicians').

dispense medicines and drugs to clients and

instruct on their use as prescribed by health

professionals.

3214

Medical and dental prosthetic technicians

Medical appliance technician, Orthotist, Orthotic

design, fit, service and repair medical and dental technician, Prosthetist, Prosthetic technician,

devices and appliances following prescriptions or Denturist, Dental technician

instructions established by a health professional.

They may service a wide range of support

instruments to correct physical medical or dental

problems such as neck braces, orthopaedic splints,

artificial limbs, hearing aides, arch supports,

dentures, and dental crowns and bridges.

Occupations included in this category normally require some medical, dental and anatomical knowledge obtained through formal training. Technicians who construct and repair precision medical and surgical instruments are excluded from here (classified under 'Trades workers').

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Classification of health workforce statistics, World Health Organization, Geneva who.int/hrh/statistics/workforce_statistics Contact: hrhstatistics@who.int

Occupation group Nursing associate professionals

ISCO code 3221

Definition

Examples of occupations classified here

Nursing associate professionals provide basic Assistant nurse, Enrolled nurse, Practical nurse

nursing and personal care for people in need of

such care due to effects of ageing, illness, injury, or

other physical or mental impairment. They provide

health advice to patients and families; monitor

patients' conditions; and implement care, treatment

and referral plans usually established by medical,

nursing and other health professionals.

Midwifery associate professionals

3222

Midwifery associate professionals provide basic Assistant midwife, Traditional midwife health care and advice before, during and after pregnancy and childbirth. They provide advice to women, families and communities on birth and emergency plans, breastfeeding, infant care, family planning and related topics; monitor health status during pregnancy and childbirth; and implement care, treatment and referral plans usually established by medical, midwifery and other health professionals.

Notes This category includes occupations for which competent performance usually requires knowledge and skills obtained as the result of study in nursing; in some cases, extensive onthe-job training may substitute for the formal education formal. The criteria for inclusion of individuals in this category should be made on the basis of the nature of the work performed in relation to this definition, and not the qualifications held by individuals or that predominate in the country.

This category includes occupations for which competent performance requires knowledge and skills in routine and emergency midwifery care acquired through formal or informal training. The criteria for inclusion of individuals in this category should be made on the basis of the nature of the work performed in relation to this definition, and not the qualifications held by individuals or that predominate in the country. Traditional and lay midwives, who provide basic pregnancy and birthing care and advice based primarily on experience and knowledge acquired informally through the traditions and practices of the communities where they originated, are included here. Birth assistants, who provide emotional support and general care and advice to women and families during pregnancy and labour, are excluded from here (classified under 'Personal care workers in health services').

Traditional and complementary medicine associate professionals

3230

Traditional and complementary medicine associate professionals prevent, care for and treat physical and mental illnesses, disorders and injuries using herbal and other therapies based on theories and experiences originating in specific cultures. They administer treatments using traditional techniques and medicaments, either acting independently or according to therapeutic care plans established by a traditional medicine or other health professional.

Acupuncture technician, Ayurvedic technician, Bonesetter, Herbalist, Homeopathy technician, Scraping and cupping therapist, Village healer, Witch doctor

This category includes occupations for which competent performance requires knowledge and skills acquired through relatively short periods of education and training, or informally through the traditions and practices of the communities where they originated. Faith healers, who treat human ailments through spiritual therapies, without using herbal therapies or other medicaments or physical treatments, are excluded from here (classified under 'Religious associate professionals'). Occupations that provide therapy using traditional forms of massage and the application of pressure, such as acupressure and shiatsu therapists, are classified under 'Physiotherapy technicians and assistants'-3255.

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Occupation group Dental assistants and therapists

ISCO code 3251

Definition

Examples of occupations classified here

Dental assistants and therapists provide basic Dental assistant, Dental hygienist, Dental therapist

dental care services for the prevention and

treatment of diseases and disorders of the teeth

and mouth, as per care plans and procedures

established by a dentist or other oral health

professional. They examine patients' mouths, teeth

and related structures to assess oral health status;

provide advice on dental hygiene; perform basic or

routine clinical dental procedures; and assisting

dentists during complex dental procedures.

Notes This category includes occupations for which competent performance usually requires formal training in dental hygiene, dental-assisting or a related field.

Medical records and health information technicians

3252

Medical records and health information

Medical records technician, Health information clerk, Occupations included in this category require knowledge of

technicians develop, implement and assess health Medical records analyst, Medical records unit

medical terminology, legal aspects of health information,

records processing, storage and retrieval systems supervisor, Clinical coder, Disease registry technician health data standards, and computer- or paper-based data

in medical facilities and other health care settings

management as obtained through formal education and/or

to meet the legal, professional, ethical and

prolonged on-the-job training. General secretarial or clerical

administrative records-keeping requirements of

workers are excluded from here.

health services delivery.

Community health workers

3253

Community health workers provide health

Community health worker, Community health aide,

education, referral and follow up, case

Community health promoter, Village health worker

management, and basic preventive health care and

home visiting services to specific communities.

They provide support and assistance to individuals

and families in navigating the health and social

services system.

Occupations included in this category normally require formal or informal training and supervision recognized by the health and social services authorities. Providers of routine personal care services and traditional medicine practitioners are not included here.

Dispensing opticians

3254

Dispensing opticians design, fit and dispense optical lenses based on a prescription from an ophthalmologist or optometrist for the correction of reduced visual acuity. They service corrective eyeglasses, contact lenses, low-vision aids and other optical devices.

Dispensing optician, Contact lens optician

This category includes occupations for which competent performance usually requires formal training in opticianry.

Physiotherapy technicians and assistants

3255

Physiotherapy technicians and assistants

Physiotherapy technician, Physical rehabilitation

provide physical therapeutic treatments to patients technician, Acupressure therapist, Electrotherapist,

in circumstances where functional movement is Hydrotherapist, Massage therapist, Shiatsu therapist

threatened by injury, disease or impairment. They

fit patients for physical supportive devices and

administer and monitor manual treatments,

electrical modality treatments, ultrasound and other

physical therapies. Therapies are usually provided

as per rehabilitative plans established by a

physiotherapist or other health professional.

This category includes occupations for which competent performance usually requires formal training in physical rehabilitation therapy or a related field. Fitness instructors, who teach body movements used in fitness routines and recreational activities, are excluded from here (classified under 'Social, cultural and related associate professionals').

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